About DID (Dissociative Identity Disorder)

Dissociative identity disorder (previously known as multiple personality disorder) is an effect of severe trauma during early childhood, usually extreme, repetitive physical, sexual, or emotional abuse.

What Is Dissociative Identity Disorder?

Most of us have experienced mild dissociation, which is like daydreaming or getting lost in the moment while working on a project. However, dissociative identity disorder is a severe form of dissociation, a mental process, which produces a lack of connection in a person's thoughts, memories, feelings, actions, or sense of identity. Dissociative identity disorder is thought to stem from trauma experienced by the person with the disorder. The dissociative aspect is thought to be a coping mechanism -- the person literally dissociates himself from a situation or experience that's too violent, traumatic, or painful to assimilate with his conscious self.

Is Dissociative Identity Disorder Real?

You may wonder if dissociative identity disorder is real. After all, understanding the development of multiple personalities is difficult, even for highly trained experts. But dissociative identity disorder does exist. It is the most severe and chronic manifestation of the dissociative disorders that cause multiple personalities.

Other types of dissociative disorders defined in the DSM-IV, the main psychiatry manual used to classify mental illnesses, include dissociative amnesia, dissociative fugue, and depersonalization disorder.

What Are the Symptoms of Dissociative Identity Disorder?

Dissociative identity disorder is characterized by the presence of two or more distinct or split identities or personality states that continually have power over the person's behavior. With dissociative identity disorder, there's also an inability to recall key personal information that is too far-reaching to be explained as mere forgetfulness. With dissociative identity disorder, there are also highly distinct memory variations, which fluctuate with the person's split personality.

The "alters" or different identities have their own age, sex, or race. Each has his or her own postures, gestures, and distinct way of talking. Sometimes the alters are imaginary people; sometimes they are animals. As each personality reveals itself and controls the individuals' behavior and thoughts, it's called "switching." Switching can take seconds to minutes to days. When under hypnosis, the person's different "alters" or identities may be very responsive to the therapist's requests.

Along with the dissociation and multiple or split personalities, people with dissociative disorders may experience any of the following symptoms:

• Depression
• Mood swings
• Suicidal tendencies
• Sleep disorders (insomnia, night terrors, and sleep walking)
• Anxiety, panic attacks, and phobias (flashbacks, reactions to stimuli or "triggers")
• Alcohol and drug abuse
• Compulsions and rituals
• Psychotic-like symptoms (including auditory and visual hallucinations)
• Eating disorders

Other symptoms of dissociative identity disorder may include headache, amnesia, time loss, trances, and "out of body experiences." Some people with dissociative disorders have a tendency toward self-persecution, self-sabotage, and even violence (both self-inflicted and outwardly directed). As an example, someone with dissociative identity disorder may find themselves doing things they wouldn't normally do such as speeding, reckless driving, or stealing money from their employer or friend, yet they feel they are being compelled to do it. Some describe this feeling as being a passenger in their body rather than the driver. In other words, they truly believe they have no choice.

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Dissociative Identity Disorder

What is dissociative identity disorder (DID)?

Dissociative identity disorder (DID), previously referred to as multiple personality disorder, is a dissociative disorder involving a disturbance of identity in which two or more separate and distinct personality states (or identities) control an individual's behavior at different times. When under the control of one identity, a person is usually unable to remember some of the events that occurred while other personalities were in control. The different identities, referred to as alters, may exhibit differences in speech, mannerisms, attitudes, thoughts and gender orientation. The alters may even present physical differences, such as allergies, right-or-left handedness or the need for eyeglass prescriptions. These differences between alters are often quite striking.
A person living with DID may have as few as two alters or as many as 100. The average number is about 10. Often alters are stable over time, continuing to play specific roles in the person's life for years. Some alters may harbor aggressive tendencies, directed toward individuals in the person's environment or toward other alters within the person.
At the time a person living with DID first seeks professional help, he or she is usually not aware of their condition. A very common complaint in people affected by DID is episodes of amnesia, or time loss. These individuals may be unable to remember events in all or part of a proceeding time period. They may repeatedly encounter unfamiliar people who claim to know them, find themselves somewhere without knowing how they got there or find items that they don't remember purchasing among their possessions.

What are the symptoms of DID?

Often people living with DID are depressed or even suicidal and self-mutilation is common in this group. Approximately one-third of individuals affected complain of auditory or visual hallucinations.
While the causes are unknown, statistics show that DID occurs in 0.01 to 1 percent of the general population. DID is a serious mental illness that occurs across all ethnic groups and all income levels. It affects women nine times more than men.
In addition to experiencing separate identities, individuals living with DID may also experience many other symptoms. Some of these symptoms include:

• Depression.
• Suicidal tendencies.
• Anxiety, panic attacks.
• Alcohol and drug abuse.
• Confusion.
• Memory problems.
• Delusions.
• Headaches.
• Flashbacks.
• Eating disorders.
• Personality change.
• Selective loss of memory.
• Disorientation.

What does treatment for DID look like?

Treatment for DID consists primarily of psychotherapy with hypnosis. The therapist attempts to make contact with as many alters as possible and to understand their roles and functions in an individual’s life. In particular, the therapist seeks to form an effective relationship with any personalities that are responsible for violent or self-destructive behavior and to curb this behavior. The therapist aims to establish communication among the personality states and to find ones that have memories of traumatic events in an individual’s past. The goal of the therapist is to enable the individual to achieve breakdown of the patient's separate identities and their unification into a single identity.
Retrieving and dealing with memories of trauma is important for a person living with DID, because this disorder is believed to be triggered by physical or sexual abuse in childhood. Young children have a pronounced ability to dissociate and it is believed that those who are abused may learn to use dissociation as a defense. In effect, the child slips into a state of mind in which it seems that the abuse is not really occurring to him or her, but to somebody else. In time, such a child may begin to emotionally and cognitively split into alternate identities. Research has shown that the average age for the initial development of alters is 5.9 years old.
In individuals where dissociation is thought to be a symptom of another mental illness such as borderline personality disorder (BPD) orposttraumatic stress disorder (PTSD), treatment of the primary cause is of upmost importance.
Children affected by DID may experience a great variety of symptoms, including depressive tendencies, anxiety, conduct problems, episodes of amnesia, difficulty paying attention in school and hallucinations. Often these children are misdiagnosed as having schizophrenia. By the time the child reaches adolescence, it is less difficult for a mental health professional to recognize the symptoms and make a diagnosis of DID.

What can a friend or family member do to help someone who lives with DID?

• Be informed. Learn all you can about DID.
• While a friend or family member can help and support a person living with DID, they need professional help to support their recovery process. You can help them locate a therapist who is trained and experienced in treating the condition and encourage them to attend therapy appointments regularly.
• Agree to attend a therapy appointment with your loved one, if he or she is open to it. The therapist can give you some more information about DID and help you find additional ways to help.
• If your friend or loved one living with DID “switches” to another alter, they may sound and act differently and this change can be abrupt. They may not know who you are. Introduce yourself if they don't know you and offer reassurance if they are frightened.
• Peer support is vitally important to many who live with mental illness. Therefore, you can encourage your loved one to join a support group for people living with DID or a peer support group for people living with mental illness, such as NAMI Connection Recovery Support Groups.
• Be aware of signs that your loved one might be at risk for suicide as this is not uncommon for someone affected by DID. If you think they may be at risk for harming themselves, call the Suicide Hotline at 1(800) 273-TALK, get them professional help as soon as possible or take them to the nearest emergency room.
• Be willing to simply listen if your loved one wants to talk. Listening without interruption and without judging when your friend or loved one wants to talk is extremely helpful. You don’t need to try to solve their problems; just listen.